32. Eye Care and Retinopathy

Diabetes Planned Visit Notebook

Summa Health System developed this fact sheet for patients with diabetes to help them understand the importance of eye care. Care providers give it to patients during diabetes planned visits, and it is part of the Diabetes Planned Visit Notebook.

Eye Care And Retinopathy

You may have heard that diabetes causes eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes.

Most people who have diabetes have nothing more than minor eye disorders. You can keep minor problems minor. And when you do get a major problem, there are treatments that often work well if you begin them right away.

Glaucoma

You must be regularly tested by an optometrist or ophthalmologist. People with diabetes are more likely than others to suffer from the eye disorder glaucoma. The longer someone has had diabetes, the more common glaucoma is. Risk also increases with age.

In glaucoma, pressure builds up in the eye. The pressure pinches the blood vessels taking blood to the retina and optic nerve. Vision is gradually lost as the retina and nerve are damaged.

There are several treatments for glaucoma. Some use drugs to reduce pressure in the eye, while others involve surgery.

Cataracts

Many people without diabetes get cataracts, but people with diabetes are more likely to develop this eye condition. In cataracts, the eye's clear lens clouds, blocking light from entering. To help deal with mild cataracts, you may need to wear sunglasses more often and to have glare-control lenses put in your glasses.

For cataracts that interfere greatly with vision, doctors usually remove the lens of the eye. In people with diabetes, retinopathy can get worse after removal of the lens, and glaucoma may start to develop.

Retinopathy

Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes.

Nonproliferative retinopathy is the common, milder form. This form is also called background retinopathy. It usually has no effect on vision and needs no treatment. But once it's diagnosed, be sure to have your eyes checked at least yearly to make sure it's not getting worse.

In nonproliferative retinopathy, the retina becomes swollen and fatty deposits form within it. If this swelling affects the center of the retina, the problem is called macular edema. Vision loss can result.

In some people, retinopathy progresses after several years to a more serious form called proliferative retinopathy. In this form, the blood vessels are so damaged that they close off. In response, new blood vessels start growing in the retina. These new vessels are weak and can leak blood, blocking vision, a condition called vitreous hemorrhage.

The new blood vessels can also cause scar tissue to grow. Once the scar tissue shrinks, it can distort the retina or pull it out of place (retinal detachment). The retina can be badly damaged before a person notices any change in vision or has any symptoms. For this reason, you should have your eyes examined by an eye doctor regularly.

Who's at Risk?

The longer you've had diabetes, the more likely you are to have retinopathy. Almost everyone with type 1 diabetes will one day have nonproliferative retinopathy. And most people with type 2 diabetes will also get it. But the retinopathy that destroys vision, proliferative retinopathy, is far less common.

People who keep their blood glucose levels closer to normal are less likely to have retinopathy and to have milder forms if they do.

Treating Retinopathy

Huge strides have been made in the treatment of diabetic retinopathy. The earlier retinopathy is diagnosed, the more likely these treatments will be successful.

In photocoagulation (laser treatment), the doctor makes tiny burns on the retina with a special laser. These burns seal the blood vessels and stop them from growing and leaking.

Preventing Eye Problems

First and most important, keep your blood glucose levels under tight control.

Second, bring high blood pressure under control. High blood pressure can make eye problems worse.

Third, quit smoking. Some studies have found that people who smoke are more likely to get retinopathy.

Fourth, see an eye doctor regularly. Only a special exam can find the early stages of retinopathy. A skilled eye doctor must dilate your pupils with drops and check your retinas.

Having your regular doctor look at your eyes is not enough. Nor is having your eyeglass prescription tested by an optician. Only optometrists and ophthalmologists can detect the signs of retinopathy. Only ophthalmologists can treat retinopathy.

Fifth, see your eye doctor if:

Your vision becomes blurry.

You have trouble reading signs or books.

You see double.

Your eye hurts.

You feel pressure in your eye.

Your eye gets red and stays that way.

You see floating spots or flashing lights.

Straight lines do not look straight.

You can't see things at the side as you used to.

Questions about Eye Care and Retinopathy? Please call the Family Medicine Center at 330 375-3584 or 1-800-460-2332.